New Affordable Care Act numbers reveal “coverage gap” in Texas

In a blog I had written in early February, we reported that over 1.3 million Texans signed up for the ACA Marketplace health insurance plans for 2016.  Recently, US Department of Health and Human Services released county-level and zip-code level qualified health plan enrollment data in the ACA marketplace during the 2016 Open Enrollment Period (November 1, 2015 – February 1, 2016).

In the interactive map below, we have represented the ACA marketplace enrollment data for each Texas county. Counties with less than 10 enrollees are excluded from the analysis. Click here or on the map below to view the map.
ACA health insurance enrollment map 2016.png
The data tells us that Harris County had the largest ACA enrollment figure among all counties in Texas.  The total marketplace enrollment of 239,656 in Harris County is 18% of the state total figure.  This is followed by Dallas County (132,637), Tarrant County (100,833), Bexar County (92,692), Travis County (73,093), El Paso County (62,922), Collin County (49,542), Fort Bend County (47,509), Denton County (38,884) and Hildago County (38,134).  Altogether, the ACA marketplace enrollment in these 10 counties make up 67% of the state total.
The above interactive map will be a great tool for organizations engaged in ACA outreach and enrollment activities to use as they prioritize their future strategies and resources.  Also, as reported by DHHS, we also recently learned that close to half of the ACA marketplace enrollees in Texas are new enrollees.  EHF recent analysis of the HRMS survey also suggests that many insured Texans had difficulty understanding common health insurance terms and using their health plans.  Therefore, there is a continuing need to help promote health insurance literacy and to help these new enrollees to access and navigate health services in their communities.  
While it is great to showcase the successes of these counties in enrolling large number of Texans in the ACA Marketplace, let us also not forget the 766,000 Texas who fall into coverage gap due to Texas refusal to expand Medicaid.  The coverage gap population are those who earn too much to qualify for Medicaid assistance, but not enough to get federal subsidies offered under the ACA Marketplace.  The recent analysis by the Kaiser Family Foundation reveals that nearly seven in 10 Texans who fall in the coverage gap are racial/ethnic minorities and are in a family with workers – either they or a family member is employed either part-time or full-time.  This suggests that the state’s refusal to expand Medicaid will continue to have a disproportionate impact in racial/ethnic minority communities, as well as poor working families in Texas.